Friday, June 26, 2015

Over testing vs. patient concerns

A new study in Canada states that early stage breast cancer patients are getting too many pretreatment imaging tests. An average of four after diagnosis. That's a lot.

In my case I had a mammogram that went bad and led to an ultrasound followed by a biopsy and a diagnosis. Then my surgeon sent me for an MRI to confirm there was nothing else. Then two surgeries, chemo, radiation, and hormone treatment. At some point a couple years after radiation,  I had a PET scan to confirm some aches and pains nothing - mostly because I was freaking out. Now I just have mammograms. As well as too many doctors wanting to check for lumps.

I am not sure what other tests I could have or should have had. Or needed. I think I got my share of radiation through all of that. So I am not sure what other screens I really needed.

But let's go back to the freak out I went through and a doctor sent me for what was probably an unneeded PET scan that found nothing. (I  no longer see this doctor, my radiation oncologist, as she used to tell me I shouldn't work because I had cancer and my husband should support me fully and other stupid statements.) This makes me wonder how many other doctors send patients for unneeded scans just because the patient mistakenly believes they have metastases. The doctor does the easy thing and sends them for some test so they do not have to deal with the freak out part.

In my opinion this goes back to the bedside manner stuff that isn't very present in medical school. If a patient is stressed about something, I do not think that sending someone for scans is always the right way to resolve the issue. I think it deserves an in depth conversation that includes the current screening standards, odds of their being an issue, and how to cope with the stress.

I asked my back pain doctor about more scans for my back as it had been five years since my last spine MRI. His response was there is no need for one as nothing indicated anything had changed. I can live with that kind of response. It keep me from being stressed - no indication of any changes. What if that my radiation oncologist had started a conversation with me about reasons the PET scan was not indicated?

In view of increased medical over spending and over treatment concerns, more conversations are warranted instead of more testing.

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